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Diet Drinks Harm Teeth as Much as Sugared Drinks

Scientists at the University of Melbourne in Australia tested 23 different types of drinks and found that those that are acidic soften tooth enamel to damage teeth even if they contain no sugar at all (General Dentistry, May/June, 2015).

Many sugared and non-sugared drinks, sports drinks, energy drinks, diet drinks, flavored waters and carbonated drinks contain citric and phosphoric acids, added to enhance flavor and prolong shelf life. The researchers found that sugar-free drinks with citric acid are a major cause of tooth erosion, and eroded tooth enamel allows bacteria to enter the teeth to cause further damage.

It's The Acid
The researchers measured fluoride content, acidity (pH), and titratable acidity of 13 sports drinks and nine energy drinks, including Gatorade and Red Bull. Titratable acidity measures how long it takes for saliva to neutralize a drink's effect of acidifying the mouth. They also placed molar teeth in a petri dish full of each beverage for 15 minutes, then put the teeth in artificial saliva for two hours, and repeated this procedure four times a day for five days. Then they measured how much enamel was removed from the teeth by each beverage. The teeth lost a lot of enamel after exposure to almost all of the acid drinks, with the energy drinks taking off more enamel than the sports drinks.

The United States government does not require beverage companies to have a label that states the amount of citric acid in their drinks. Previous research has shown that acids in citrus fruit juices, particularly lemon juice, also can erode enamel from teeth. Other data show that citric acid may also erode bone to increase risk for osteoporosis.

How Both Sugared and Sugarless Drinks Can Cause Decay
More than 60 years ago, researchers showed that sugared drinks cause cavities. The bacteria in your mouth eat the same foods that you do, so when you eat a lot of sugar, the types of bacteria that also eat sugar grow abundantly in your mouth. When bacteria eat sugar, they release potent acids that acidify your mouth. Acids in your mouth can dissolve the outer enamel coating of your teeth to form cavities. The sugar industry has been aware of the harmful effects on the teeth for 60 years and tried to influence the Scientific Agenda of the National Institute of Dental Research’s 1971 National Caries Program (PLOS Medicine, March 10, 2015). Now we learn that sugarless acid-containing drinks also erode teeth which exposes them to decay.

My Recommendations
• Check the label on all drinks for acidic additives, particularly sugars, artificial sweeteners, citric acid and phosphoric acid.
• Drink plain water as your first choice for hydrating and quenching thirst. Plain unsweetened coffee or tea are acceptable non-acidic alternatives.
• Don’t brush your teeth immediately after eating or drinking acidic products, since brushing can remove the weakened enamel. Rinse your mouth with plain water after eating and wait at least an hour before brushing.
• If your drinking water does not contain fluoride, check with your dentist about an alternate source, such as fluorinated tooth paste.
• Do not believe beverage advertising claims about using their products to get electrolytes, vitamins and so forth. Beverages with these additives almost always contain acids and sweeteners. You get the nutrients you need from your food.
• Limit fruit juices, soft drinks, sports drinks, energy drinks and diet sodas. I recommend that you use sugared drinks ONLY during prolonged, intense exercise. The rest of the time, drink water.

December 6th, 2015
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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